Diabetes Forecast

Facing Changes

Lessening the stress of diabetes changes for kids

By Linda A. DiMeglio, MD, MPH, Associate Editor , ,
child measuring height on blackboard with chalk drawing of dinosaur on blackboard


In life, change is inevitable. Children with diabetes and their caregivers experience several distinct transitions related to coping with the diagnosis and disease. The first transition usually involves adapting to the daunting news that diabetes is part of the family. For many, the next, more gradual progression is from the parents providing nearly all aspects of care to the children doing more and more themselves. There is often a third, later-childhood transition: when adolescents and young adults find themselves responsible for all aspects of self-care and move from a pediatric to an adult medical care team.

Life transitions around management of a chronic disease often provoke anxiety. Fortunately, there are several ways to lessen the stress.

First, make sure that, when possible, changes are anticipated and planned. For example, if a transition in your care provider team is necessary, whether because of a move, change in insurance, or “aging out” of a clinic setting, start doing research as soon as you are aware of the need for change. Your current health care team may have recommendations for whom you might want to see. And if the new team isn’t a good fit, don’t be afraid to ask your prior team for another recommendation. 

Second, practice really can make perfect. Before you send older children with diabetes on an overnight trip, have them spend a day out with friends (and adult supervisors you trust). Make sure they consider what they will need to do throughout the day and ensure they have a plan in place. When they get home, take the time to sit down with them and review their meters and log books. Discuss where the plan succeeded or failed: Praise what went well and use any struggles as teachable moments.

Third, don’t be afraid to acknowledge emotions related to change—whether you’re the caregiver or the person with diabetes. For example, when transitions are unanticipated or unplanned, they can feel overwhelming, and you might be angry or upset. If you feel like crying, go ahead!  After a good cry, you can feel more relaxed and more positive.

It is also important to reflect on other changes in your life. Remember that you made it through those times and that the stress you are feeling is temporary. Connecting with and leaning upon others who have been through similar transitions can also be of benefit. Of course, if after trying all of these things you still find yourself mad or sad, seeing a counselor might be helpful.

Changes are unavoidable. It is important, however, to recognize that they offer prospects and even benefits. Use transitions as an opportunity to grow whenever possible.



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